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Intraoperative hypotension and its prediction
Jaap J Vos, Thomas W L ScheerenIndian Journal of Anaesthesia 2019 63(11):877-885 Intraoperative hypotension (IOH) very commonly accompanies general anaesthesia in patients undergoing major surgical procedures. The development of IOH is unwanted, since it is associated with adverse outcomes such as acute kidney injury and myocardial injury, stroke and mortality. Although the definition of IOH is variable, harm starts to occur below a mean arterial pressure (MAP) threshold of 65 mmHg. The odds of adverse outcome increase for increasing duration and/or magnitude of IOH below this threshold, and even short periods of IOH seem...
Source: Indian Journal of Anaesthesia - November 7, 2019 Category: Anesthesiology Authors: Jaap J Vos Thomas W L Scheeren Source Type: research

Evaluation of Neurocognitive Abilities in Patients Undergoing Carotid Endarterectomy Surgery
CONCLUSION: The purpose of CEA in the past was the prevention of ischemic stroke and cerebrovascular disease (CVD) rather than neurocognitive recovery. Factors affecting neurocognition in CEA are multifactorial. Preservation and improvement of neurocognition are more important than any other period of history. By prioritizing cognitive abilities in the treatment of carotid stenosis, individualization of the treatment will help maximize the increase in cognitive abilities by providing optimum benefit to the patient of each factor.PMID:33635257 | DOI:10.1532/hsf.3371
Source: The Heart Surgery Forum - February 26, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Zafer Cengiz Er Kivanc Atilgan Source Type: research

Machine learning methods to improve bedside fluid responsiveness prediction in severe sepsis or septic shock: an observational study, British journal of anaesthesia
Conclusions: Machine learning generated several models for predicting fluid responsiveness that were comparable with the haemodynamic response to PLR.
Source: Current Awareness Service for Health (CASH) - May 6, 2021 Category: Consumer Health News Source Type: news

Bringing WISDOM to Breast Cancer Care
Dr. Laura Esserman answers the door of her bright yellow Victorian home in San Francisco’s Ashbury neighborhood with a phone at her ear. She’s wrapping up one of several meetings that day with her research team at University of California, San Francisco, where she heads the Carol Franc Buck Breast Care Center. She motions me in and reseats herself at a makeshift home office desk in her living room, sandwiched between a grand piano and set of enormous windows overlooking her front yard’s flower garden. It’s her remote base of operations when she’s not seeing patients or operating at the hospita...
Source: TIME: Health - October 22, 2021 Category: Consumer Health News Authors: Alice Park Tags: Uncategorized Source Type: news

Pass On What You Have Learned: A Structured Mentor-Mentee Concept for the Implementation of a Minimally Invasive Mitral Valve Surgery Program
Conclusion: Typically, excellent exposure and high repair rates of the MV has led us offer MICS approach to a majority of patients with isolated MV disease. Careful planning and a strict mentor-mentee concept facilitated a safe startup of an MICS program in a busy university heart center.Eur Surg Res
Source: European Surgical Research - December 1, 2021 Category: Surgery Source Type: research

Central Hypovolemia Detection During Environmental Stress —A Role for Artificial Intelligence?
The first step to exercise is preceded by the required assumption of the upright body position, which itself involves physical activity. The gravitational displacement of blood from the chest to the lower parts of the body elicits a fall in central blood volume (CBV), which corresponds to the fraction of thoracic blood volume directly available to the left ventricle. The reduction in CBV and stroke volume (SV) in response to postural stress, post-exercise, or to blood loss results in reduced left ventricular filling, which may manifest as orthostatic intolerance. When termination of exercise removes the leg muscle pump fun...
Source: Frontiers in Physiology - December 15, 2021 Category: Physiology Source Type: research

What is Ondine ’ s Curse?
Discussion Congenital central hypoventilation syndrome (CCHS) is an autosomal dominant with variable inheritance genetic disease caused by mutation in the Paired Like Homeobox B2 (PHOX2B) gene on chromosome 4. There are two other genes which may also cause CCHS. CCHS affects the chemoreceptor afferent ventilation pathways and is a neural crest migration problem of the autonomic nervous system. The incidence is unknown but a prevalence of 1 in 200,000 live births has been reported. Obviously it is a rarer phenomenon because of the general lethality of the syndrome. Patients usually present at birth or soon afterwards, but o...
Source: PediatricEducation.org - August 15, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Hypotension Prediction Index guided Goal Directed therapy and the amount of Hypotension during Major Gynaecologic Oncologic Surgery: a Randomized Controlled clinical Trial
AbstractIntraoperative hypotension (IOH) is associated with increased morbidity and mortality. Hypotension Prediction Index (HPI) is a machine learning derived algorithm that predicts IOH shortly before it occurs. We tested the hypothesis that the application of the HPI in combination with a pre-defined Goal Directed Therapy (GDT) hemodynamic protocol reduces IOH during major gynaecologic oncologic surgery. We enrolled women scheduled for major gynaecologic oncologic surgery under general anesthesia with invasive arterial pressure monitoring. Patients were randomized to a GDT protocol aimed at optimizing stroke volume inde...
Source: Journal of Clinical Monitoring and Computing - April 29, 2023 Category: Information Technology Source Type: research

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